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Treatment for GERD and Barrett's Esophagus

Until recently, the best way to care for patients with Barrett's esophagus without cancer was to simply monitor patients with periodic endoscopy. Once cancer was detected, or more worrisome changes suggesting a progression to cancer were seen, the patient was referred for surgery. However, we now have at our disposal at Fox Chase some very useful treatments via the endoscope. These valuable treatments can, in many cases, prevent the need for surgery and the development of cancer.

When treating complex conditions like GERD & Barrett’s esophagus, more experience can lead to better outcomes. At Fox Chase Cancer Center, our multidisciplinary team of surgical oncologists, medical oncologists, radiation oncologists, gastroenterologists, pathologists and radiologists work closely to correctly assess your GERD & Barrett’s esophagus and help you understand your options, so that you can make an informed decision about your treatment.

We believe the care of patient's Barrett's esophagus must be individualized. At Fox Chase, our philosophy is to provide compassionate care based on a thorough, personalized assessment of the patient's condition, taking into account the patient's overall medical history, his or her individual priority and needs, and a careful analysis of biopsy material.

We welcome the opportunity to provide second opinions to patients who may need advanced care.

Surgery

Fox Chase surgical oncologists offer an individually tailored surgical approach to Barrett’s esophagus that integrates the patient’s functional status and stage.

Today, using minimally invasive techniques, such as video assisted thoracic surgery (VATS), surgeons can perform esophagectomies with fewer complications, improved quality of life and better outcomes, and without compromising oncologic principles.

Surgical oncologists at Fox Chase Cancer Center are regional and national leaders in performing complex surgeries for patients with Barrett’s esophagus.

Ablative Techniques

Ablative techniques, such as Radiofrequency Ablation (RFA), use a special catheter inserted through a standard endoscope, which generates energy to cauterize and eradicate the Barrett's cells. Research studies have shown that this technique is safe and effective in the vast majority of cases in eliminating Barrett's tissue with dysplastic (precancerous) cells.

In cryotherapy, the physician applies liquid nitrogen spray through the endoscope to eliminate Barrett's tissue. Like radiofrequency ablation, this technique appears to be quite effective in eradicating Barrett's cells. Fox Chase is one of the few centers in the Delaware Valley that can offer this treatment. Cryotherapy appears to be safe and effective not only in eliminating dysplastic Barrett's tissue; we also use this technique in some patients with cancer of the esophagus to reduce the size of esophageal tumors and improve patients' ability to swallow.

Endoscopic Techniques

For patients with Barrett's esophagus and nodules, or some early cancer in Barrett's, we perform upper endoscopy with endoscopic ultrasound to assess the thickness of the nodule or lymph node involvement. This helps guide our approach to treatment.

For patients with Barrett's esophagus with localized precancerous nodules, or some very early cancers, an effective treatment is Endoscopic Mucosal Resection (EMR). In this procedure, the physician performs an endoscopy and mechanically removes the abnormal nodular tissue using specialized accessories designed expressly for this purpose. Unlike RFA and cryotherapy, EMR provides tissue for biopsy. At Fox Chase, our highly trained and experienced physicians are skilled in advanced endoscopic techniques.

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